GLP-1 drugs. An honest guide.
Roughly one in eight US adults has tried one. The efficacy is real, the side effects are real, and almost nobody selling them wants to talk about the year after you stop. We read the literature on every major question and wrote it down — not anti-pharma, not pro-pharma.
8
Cornerstone essays
2/3
Regain at 1yr off-drug
$0
Cost to read all of it
Three things the advert
leaves out
Everything in this cluster is written for one situation: you are on a GLP-1, considering one, or trying to come off one, and you want the research rather than a sales page. Every claim here is sourced to the trial or review it came from.
If you are currently on a GLP-1, coordinate every change — dose, timing, stopping — with your prescribing physician. These essays are educational scaffolding for that conversation. They are not medical advice and they do not replace the clinician who knows your history.
Trial-grade
The efficacy is real
Semaglutide and tirzepatide produced the largest average weight change of any non-surgical intervention in randomised trials. We do not pretend otherwise.
Two-thirds
The exit is the problem
In the STEP 1 extension, about two-thirds of lost weight had returned a year after stopping, and cardiometabolic markers drifted back toward baseline.
25–40%
Some of it is muscle
Body-composition substudies put a quarter to two-fifths of the weight lost in the lean-mass column when protein and resistance training are not deliberately defended.
8 cornerstone essays
Filter by where you are in the process. Every essay carries its citations and a review date.
Showing 8 of 8 essays
- On the drug
The GLP-1 Side Effects Nobody Mentions in the 30-Second Ad
Beyond nausea and constipation — gastroparesis, ozempic face, vision concerns, mental health effects, pancreatitis. The full side-effect picture and how to manage each.
Read9 min · May 2026 - Coming off
GLP-1 Rebound Weight Prevention: Why Most Regain and How to Be the Exception
Two-thirds regain at one year is the trial-data baseline. Here's the mechanism — leptin set-point defense, ghrelin rebound, lean-mass deficit — and the protocol that consistently produces the better third.
Read9 min · May 2026 - Deciding
Ozempic vs Mounjaro vs Wegovy: An Honest Comparison
Mechanism differences (GLP-1 alone vs dual GLP-1/GIP), trial-data effectiveness, side-effect profiles, cost and access. The choice that actually matters and what's marketing noise.
Read8 min · May 2026 - Deciding
Should I Take Ozempic? An Honest Decision Framework
Who genuinely benefits, who probably shouldn't, what the cost calculus actually looks like, and the lifestyle-first alternative when it works (and when it doesn't).
Read9 min · May 2026 - Coming off
Maintaining Weight After Stopping a GLP-1 (the Real Protocol)
Two-thirds regained at one year is the trial-data baseline. Here's the structural maintenance protocol — appetite recalibration timeline, behavioral scaffolding, and the markers that predict success.
Read9 min · May 2026 - Eating
What to Eat on a GLP-1: The Protein-Fiber-Fat Priority Protocol
With reduced appetite, you can't waste calories on low-density foods. Here's the priority order — protein first, fiber second, fats third, carbs minimal — plus practical meal structures that hit your targets in small volumes.
Read9 min · May 2026 - Muscle & bone
Preventing Muscle Loss on Ozempic: The Protocol the Trials Implied
25–40% of weight lost on a GLP-1 is lean mass without active countermeasures. Linge 2024 and Jensen 2024 establish what works. Here's the protocol — protein, resistance training, sleep, micronutrients.
Read11 min · May 2026 - Coming off
Transitioning Off Ozempic: A 12-Week Off-Ramp Protocol
Two-thirds of weight regained at one year is the trial-data baseline. Here's the structured 12-week off-ramp that changes the trajectory — taper schedule, protein, strength, sleep.
Read12 min · May 2026
The drug is the easy half. The exit is the work.
Pharmacological appetite suppression is doing a job. Take it away without putting something structural in its place and the job simply stops being done. That is the whole mechanism behind the regain data.
While you are on it
Appetite is handled for you
- Gastric emptying slows and satiety signalling is amplified
- Portions shrink without a decision being made
- Weight comes down; several cardiometabolic markers improve with it
- Lean mass quietly leaves too, unless it is actively defended
The week you stop
Something has to take over
- A protein floor high enough to protect what muscle you still have
- Resistance training two to three times a week, progressively loaded
- Ultra-processed food removed from the house, not just from the plan
- A sleep window defended like an appointment — appetite depends on it
- A taper agreed with your prescriber, never a cold stop
GLP-1 questions
What people actually ask us
They work, and the effect size in the registration trials is larger than anything else available short of bariatric surgery. Semaglutide 2.4 mg and tirzepatide 15 mg both produced double-digit average percentage weight change over roughly 68–72 weeks against a low-single-digit placebo response.
The honest caveat is that these are group averages from supervised trials with intensive support, not a forecast for any one person. Response varies widely, a minority are non-responders, and the numbers describe time on the drug — not what happens afterwards.
The honest comparisonMean total body weight change at 68 weeks
Mean total body weight change at 72 weeks
Same trials, same lifestyle support
Trial figures are group averages from published randomised trials, cited in the essays above. They describe study populations, not you — individual response varies and no outcome is guaranteed.
Coming off, or thinking about it?
The Transition Planner turns this cluster into a twelve-week structure built around your medication and your starting point — to take to your prescriber, not instead of them.
Educational only, not medical advice. Nothing here is a prescription, a diagnosis, or a recommendation to start, change or stop any medication. Consult your physician before major dietary changes or altering prescribed medication. These statements have not been evaluated by the Food and Drug Administration. Individual results vary; no outcome is guaranteed.